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Alabama Medicaid waivers that pay for home care

Last verified October 17, 2026 · All Alabama resources

Alabama Medicaid pays for in-home personal care and related services through 5 programs, including the Elderly and Disabled (E&D) Waiver and the Alabama Community Transition (ACT) Waiver. The Alabama Medicaid Agency oversees the waivers. The Department of Senior Services operates E&D, ACT, and TA; Rehabilitation Services operates SAIL; the Department of Mental Health operates ID, LAH, and the Community Waiver Program. Confirm adult state plan personal care and EVV requirements for E&D and ACT with the Alabama Medicaid Agency.

Which Alabama waivers can a home care agency bill?

Each waiver below lists who it covers, the services it pays for, and how providers bill.

Elderly and Disabled (E&D) Waiver

Population
People who are elderly and/or disabled, meet the nursing facility level of care, and have income up to $2,982 per month and resources up to $2,000.
Services covered
  • case management
  • homemaker
  • personal care
  • respite (skilled and unskilled)
  • adult companion
  • adult day health
  • home delivered meals
  • personal emergency response system
  • home modifications
  • skilled nursing
Billing format
Not specified
Prior authorization
Required
Open waiver page (opens in a new tab)

Alabama Community Transition (ACT) Waiver

Population
People with disabilities or long-term illnesses who live in an institution, meet nursing facility level of care, and want to move home or to the community.
Services covered
  • case management
  • transitional assistance
  • personal care
  • homemaker
  • adult companion
  • skilled/unskilled respite
  • adult day health
  • home delivered meals
  • personal emergency response system
Billing format
Not specified
Prior authorization
Required
Open waiver page (opens in a new tab)

State of Alabama Independent Living (SAIL) Waiver

Population
Adults 18 and older with specific diagnoses (for example quadriplegia, traumatic brain injury, ALS, MS) who meet nursing facility level of care.
Services covered
  • case management
  • personal care
  • personal assistance services
  • personal emergency response system
  • environmental accessibility adaptations
  • assistive technology
Billing format
Not specified
Prior authorization
Required
Open waiver page (opens in a new tab)

Intellectual Disabilities (ID) Waiver

Population
People age 3 and older with an intellectual disability who meet the ICF/IID level of care.
Services covered
  • personal care
  • adult companion
  • in-home respite
  • out-of-home respite
  • day habilitation
  • supported living
  • residential habilitation
  • supported employment
  • remote supports
Billing format
EVV is required; ADMH says workers clock in and out with a cell phone app or IVR when providing personal care, companion care, or skilled nursing.
Prior authorization
Required
Open waiver page (opens in a new tab)

Living at Home (LAH) Waiver

Population
People age 3 and older with an intellectual disability who meet the ICF/IID level of care and are in a qualifying Medicaid group such as SSI.
Services covered
  • personal care
  • adult companion
  • in-home respite
  • out-of-home respite
  • day habilitation
  • community experience
  • remote supports
Billing format
EVV is required; ADMH says workers clock in and out with a cell phone app or IVR when providing personal care, companion care, or skilled nursing.
Prior authorization
Required
Open waiver page (opens in a new tab)

Sources

More for Alabama

Medicaid waiver lookup: other states

Related guides

Authorizations

How to Become a Medicaid Provider for Home Care

To bill Medicaid for home care you need a state license, a Type 2 NPI, state Medicaid enrollment and screening, waiver or managed care contracts, EVV and authorizations.

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